When parents are expecting multiples the need for support is undeniable! Doula and Multiples Specialist, Julia Schetky tells us about her role during the immediate postpartum as well as her advice for planning for the postpartum time at home.
Can you tell us a little about your role as a labor doula assisting births of twins and triplets?
My second birth I attended as a doula was to a wonderful friend who was expecting twins. I learned very quickly that pregnancy and birth with multiples is a very different experience as a doula than births of singletons. First off, twin pregnancies are way more medically managed. My clients see not only their OB, but Maternal Fetal Medicine providers, making their appointment 2-3 times more frequent than mother’s with a low-risk singleton. Many more questions come up prenatally as a result, and I often see them more than my typical 1-2 prenatal visits. Depending on the type of twins they are having, clients may also be in the hospital as an inpatient at the end of their second trimester. In addition, locally, hospital policy is to have mother’s push in the OR in the case of something not going to plan. So, my clients labor in their rooms, then move when they need to push. My role during their birth is to normalize their experience, and especially to help them close out all the noise when they move from place to place. Another huge role is remaining with the mother if her first baby is taken to the NICU. In that instance, the partner goes with the baby, and I am left to help the mother push their second (or even third) baby into the world! Without a doula, she would be birthing on their own. This is a huge deal to my clients, and often that alone is what encourages them to hire a doula. And finally, I focus on taking as many photos as possible. Usually my photos are the only ones they have from their birth, so this is a huge deal for my clients.
How do you help when the babies are first born and during the hospital stay?
I remain with my clients for 1-2 hours in the immediate postpartum time. However, I do find that I leave earlier with my twins clients. The reason for this is that many times the amount of people involved in a twin birth can be overwhelming. Often my clients share than they would like to be alone for a bit of time after the babies are born. I read my client’s cues and follow them, however.
What kind of good planning do you see the families of multiples doing for the postpartum time?
If you are expecting twins or triplets, I suggest a few things. First, have a meal train set up for your immediate postpartum train. If you do this, have them leave it at the door in a cooler that you provide. Secondly, plan on not bringing home both babies immediately. In many cases the mother is discharged from the hospital before both babies. Make a plan about taking shifts at the hospital. Third, meet with a twins-experienced lactation consultant prenatally AND postpartum. Make sure you have a great breast pump, and nursing stations set up. Come up with a plan with your partner on how to make sure that they do everything else. Finally, make a list of things that you can have visitors do. To gain entry to visit you or the babies, they should complete at least one task. This can help your family stay on top of those things like laundry, bottle cleaning, meal prep and shopping.
What would you like to see them do?
I would love to see more women set up their village prior to birth. For some reason, asking for help is SO hard for us mothers, but this is the time to send out your messages for help. Be direct, and have a list ready so when someone says “how can I help?” you have a specific answer!
And finally, what message would you like to send out to all postpartum women?
The only piece of advice that I held on to was this “Do what doesn’t make you crazy, and forget all the other advice.”